VA Form 21P-534a
- Form name:Application for Dependency and Indemnity Compensation by a Surviving Spouse or Child—In-Service Death Only
- Form revision date: August 2025
- Related to: Family member and caregiver benefits
When to use this form
If you’re the surviving spouse or child of a service member who died while on active duty, your military casualty assistance officer will help you to complete an Application for Dependency and Indemnity Compensation by a Surviving Spouse or Child (VA Form 21P-534a). The officer will help you mail the form to the correct VA regional office.
If you’re the surviving spouse or child of a Veteran, fill out an Application for DIC, Survivors Pension, and/or Accrued Benefits (VA Form 21P-534EZ).
Get VA Form 21P-534EZ to download
If you’re a surviving parent, fill out an Application for Dependency and Indemnity Compensation by Parent(s) (VA Form 21P-535).
Get VA Form 21P-535 to download
You can apply for this benefit in any of these ways:
- Work with an accredited attorney, claims agent, or Veterans Service Organization (VSO) representative
Get help filing a claim - Use the QuickSubmit tool through AccessVA to upload your form online
Go to AccessVA to use QuickSubmit Mail your form to this address:
Department of Veterans Affairs
Pension Intake Center
PO Box 5365
Janesville, WI 53547-5365- Go to a VA regional office and get help from a VA employee
Find a VA regional office near you